Allo-HCT refined ELN 2022 risk classification: validation of the Adverse-Plus risk group in AML patients undergoing allogeneic hematopoietic cell transplantation within the Spanish Group for Hematopoietic Cell Transplantation (GETH-TC)
Por:
Jiménez-Vicente, C, Esteve, J, Baile-González, M, Pérez-López, E, Calvo, CM, Aparicio, C, Ormategi, IO, Esquirol, A, Peña-Muñoz, F, Fernandez-Luis, S, Fernando, IH, González-Rodríguez, AP, López-García, A, López-Lorenzo, JL, Torrado, T, Marín, AJS, Fleytas, CA, García, L, Villar, S, Filaferro, S, Balsalobre, P, Cascón, MJP, Salas, MQ
Publicada:
21 mar 2025
Resumen:
This multicenter retrospective study by GETH-TC validates the prognostic value of the Allo-HCT Refined ELN 2022 risk classification in allografted AML patients. The new classification refines the ELN 2022 risk classification, dividing adverse-risk patients into two subgroups: Adv-Plus (AdvP), including those with complex karyotype, MECOM (EVI1) rearrangement, or TP53 mutations/del(17p), and an additional adverse group (Adv*). The study included 651 AML patients treated with at least one line of anthracycline-based induction therapy and in complete remission. According to the Allo-HCT Refined ELN 2022 risk classification, 19.4% (n = 126) patients were classified into the Favorable (Fav) risk, 38.1% (n = 248) into the Intermediate (Int) risk, 27.2% (n = 177) in the Adv* and 15.4% (n = 100) in the AdvP. Outcomes were significantly poorer for patients allocated in the AdvP risk group (5-year OS rate: 32.3%, 5-year LFS rate: 24.3%, both p < 0.001 with the rest of subgroups) and a higher CIR (5-year CIR: 64.3%, p < 0.001). Patients in the Adv* risk group had similar outcomes than patients in the Int risk group (5-year OS rate: 70.2% vs. 66.7%, p = 0.69, 5-year LFS rate: 63.8% vs. 55.9%, p = 0.33). Multivariate analysis confirmed the dismal outcomes for AdvP patients for OS: Hazard Ratio (HR) = 3.05, and LFS: HR = 2.66, both p < 0.001. Our findings validate the Allo-HCT Refined ELN 2022 classification as a robust prognostic tool, particularly highlighting the poor outcomes for the AdvP subgroup.
Filiaciones:
Jiménez-Vicente, C:
Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain
Esteve, J:
Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain
Baile-González, M:
Complejo Asistencial Univ Salamanca IBSAL, Salamanca, Spain
Pérez-López, E:
Complejo Asistencial Univ Salamanca IBSAL, Salamanca, Spain
Calvo, CM:
Hosp Reina Sofia, Cordoba, Spain
Aparicio, C:
Hosp Reina Sofia, Cordoba, Spain
Ormategi, IO:
Hosp Univ Donostia, Donostia San Sebastian, Spain
Esquirol, A:
Hosp Santa Creu i St Pau, Barcelona, Spain
Peña-Muñoz, F:
Hosp Duran i Reynals, Inst Catala Oncol, Barcelona, Spain
Fernandez-Luis, S:
Hosp Univ Marques Valdecilla, IDIVAL, Santander, Spain
Fernando, IH:
Hosp Gen Univ Morales Meseguer, Murcia, Spain
González-Rodríguez, AP:
Hosp Univ Cent Asturias, Oviedo, Spain
López-García, A:
Hosp Univ Fdn Jimenez Diaz, Madrid, Spain
López-Lorenzo, JL:
Hosp Univ Fdn Jimenez Diaz, Madrid, Spain
Torrado, T:
Hosp Univ A Coruna, La Coruna, Spain
Marín, AJS:
Hosp Univ 12 Octubre, Madrid, Spain
Fleytas, CA:
Hosp Univ Gran Canaria Doctor Negrin, Gran Canaria, Spain
García, L:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Villar, S:
Clin Univ Navarra, Pamplona, Spain
Filaferro, S:
Grp Espanol Trasplante Progenitores Hematopoyet &, Barcelona, Spain
Balsalobre, P:
Grp Espanol Trasplante Progenitores Hematopoyet &, Barcelona, Spain
Cascón, MJP:
Grp Espanol Trasplante Progenitores Hematopoyet &, Barcelona, Spain
Hosp Reg Univ Malaga, Malaga, Spain
Salas, MQ:
Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain
Green Submitted, gold
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